Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study
Background Many hospitalized older adults require family surrogates to make decisions, but surrogates may perceive that the quality of medical decisions is low and may have poor psychological outcomes after the patient’s hospitalization. Objective To determine the relationship between communication...
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| Veröffentlicht in: | Journal of general internal medicine : JGIM 2018-03, Vol.33 (3), p.298-304 |
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| creator | Torke, Alexia M. Callahan, Christopher M. Sachs, Greg A. Wocial, Lucia D. Helft, Paul R. Monahan, Patrick O. Slaven, James E. Montz, Kianna Burke, Emily S. Inger, Lev |
| description | Background
Many hospitalized older adults require family surrogates to make decisions, but surrogates may perceive that the quality of medical decisions is low and may have poor psychological outcomes after the patient’s hospitalization.
Objective
To determine the relationship between communication quality and high-quality medical decisions, psychological well-being, and satisfaction for surrogates of hospitalized older adults.
Design
Observational study at three hospitals in a Midwest metropolitan area.
Participants
Hospitalized older adults (65+ years) admitted to medicine and medical intensive care units who were unable to make medical decisions, and their family surrogates. Among 799 eligible dyads, 364 (45.6%) completed the study.
Main Measures
Communication was assessed during hospitalization using the information and emotional support subscales of the Family Inpatient Communication Survey. Decision quality was assessed with the Decisional Conflict Scale. Outcomes assessed at baseline and 4–6 weeks post-discharge included anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), post-traumatic stress (Impact of Event Scale-Revised), and satisfaction (Hospital Consumer Assessment of Healthcare Providers and Systems).
Key Results
The mean patient age was 81.9 years (SD 8.32); 62% were women, and 28% African American. Among surrogates, 67% were adult children. Six to eight weeks post-discharge, 22.6% of surrogates reported anxiety (11.3% moderate–severe anxiety); 29% reported depression, (14.0% moderate–severe), and 14.6% had high levels of post-traumatic stress. Emotional support was associated with lower odds of anxiety (adjusted odds ratio [AOR] = 0.65, 95% CI 0.50, 0.85) and depression (AOR = 0.80, 95% CI 0.65, 0.99) at follow-up. In multivariable linear regression, emotional support was associated with lower post-traumatic stress (β = −0.30,
p
= 0.003) and higher decision quality (β = −0.44,
p
|
| doi_str_mv | 10.1007/s11606-017-4222-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5834961</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2001634500</sourcerecordid><originalsourceid>FETCH-LOGICAL-c536t-1786ff0d8a60550576aff4dae3df21cd70ae23584821670ce1ebb1141bf328403</originalsourceid><addsrcrecordid>eNp1kc1u1DAUhSMEotPCA7BBltiwCfg6ju1hgTSMKEWqNEUDYmk5sZO6cuKp7VQKj9EnxtMp5UdidRf3nHN_vqJ4AfgNYMzfRgCGWYmBl5QQUopHxQJqUpdAl_xxscBC0FLwih4VxzFeYQwVIeJpcUSWIGrgbFHcrv0wTKNtVbJ-RF8m5Wya0UUw2rYpoos4t5fe-T4rHPpunCs_GDv2SI0abbMpdqq9s9oRnarBuhltpxB8r5KJyHfozMedTTn2h9Fo47QJaKUnl-I7tBrRpokm3NwNz_nbNOn5WfGkUy6a5_f1pPh2-vHr-qw833z6vF6dl21dsVQCF6zrsBaK4brGNWeq66hWptIdgVZzrAypakEFAcZxa8A0DQCFpquIoLg6Kd4fcndTMxjdmjEF5eQu2EGFWXpl5d-d0V7K3t_IWlR0ySAHvL4PCP56MjHJwcY2v0iNxk9RwpJjwgmjJEtf_SO98lPIJ0dJMhZW0RrvN4KDqg0-xmC6h2UAyz1xeSAuM3G5Jy5F9rz884oHxy_EWUAOgphbY2_C79H_T_0Jomm5WA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2001634500</pqid></control><display><type>article</type><title>Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study</title><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><source>SpringerLink Journals - AutoHoldings</source><creator>Torke, Alexia M. ; Callahan, Christopher M. ; Sachs, Greg A. ; Wocial, Lucia D. ; Helft, Paul R. ; Monahan, Patrick O. ; Slaven, James E. ; Montz, Kianna ; Burke, Emily S. ; Inger, Lev</creator><creatorcontrib>Torke, Alexia M. ; Callahan, Christopher M. ; Sachs, Greg A. ; Wocial, Lucia D. ; Helft, Paul R. ; Monahan, Patrick O. ; Slaven, James E. ; Montz, Kianna ; Burke, Emily S. ; Inger, Lev</creatorcontrib><description>Background
Many hospitalized older adults require family surrogates to make decisions, but surrogates may perceive that the quality of medical decisions is low and may have poor psychological outcomes after the patient’s hospitalization.
Objective
To determine the relationship between communication quality and high-quality medical decisions, psychological well-being, and satisfaction for surrogates of hospitalized older adults.
Design
Observational study at three hospitals in a Midwest metropolitan area.
Participants
Hospitalized older adults (65+ years) admitted to medicine and medical intensive care units who were unable to make medical decisions, and their family surrogates. Among 799 eligible dyads, 364 (45.6%) completed the study.
Main Measures
Communication was assessed during hospitalization using the information and emotional support subscales of the Family Inpatient Communication Survey. Decision quality was assessed with the Decisional Conflict Scale. Outcomes assessed at baseline and 4–6 weeks post-discharge included anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), post-traumatic stress (Impact of Event Scale-Revised), and satisfaction (Hospital Consumer Assessment of Healthcare Providers and Systems).
Key Results
The mean patient age was 81.9 years (SD 8.32); 62% were women, and 28% African American. Among surrogates, 67% were adult children. Six to eight weeks post-discharge, 22.6% of surrogates reported anxiety (11.3% moderate–severe anxiety); 29% reported depression, (14.0% moderate–severe), and 14.6% had high levels of post-traumatic stress. Emotional support was associated with lower odds of anxiety (adjusted odds ratio [AOR] = 0.65, 95% CI 0.50, 0.85) and depression (AOR = 0.80, 95% CI 0.65, 0.99) at follow-up. In multivariable linear regression, emotional support was associated with lower post-traumatic stress (β = −0.30,
p
= 0.003) and higher decision quality (β = −0.44,
p
< 0.0001). Information was associated with higher post-traumatic stress (β = 0.23,
p
= 0.022) but also higher satisfaction (β = 0.61,
p
< 0.001).
Conclusions
Emotional support of hospital surrogates is consistently associated with better psychological outcomes and decision quality, suggesting an opportunity to improve decision making and well-being.</description><identifier>ISSN: 0884-8734</identifier><identifier>EISSN: 1525-1497</identifier><identifier>DOI: 10.1007/s11606-017-4222-8</identifier><identifier>PMID: 29185176</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adults ; Anxiety ; Children ; Communication ; Decision making ; Decisions ; Discharge ; Emotions ; Health care ; Hospitalization ; Hospitals ; Intensive care units ; Internal Medicine ; Medicine ; Medicine & Public Health ; Mental depression ; Metropolitan areas ; Observational studies ; Older people ; Original Research ; Post traumatic stress disorder ; Psychological factors ; Quality ; Quality assessment ; Social support ; Well being</subject><ispartof>Journal of general internal medicine : JGIM, 2018-03, Vol.33 (3), p.298-304</ispartof><rights>Society of General Internal Medicine 2017</rights><rights>Journal of General Internal Medicine is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c536t-1786ff0d8a60550576aff4dae3df21cd70ae23584821670ce1ebb1141bf328403</citedby><cites>FETCH-LOGICAL-c536t-1786ff0d8a60550576aff4dae3df21cd70ae23584821670ce1ebb1141bf328403</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5834961/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5834961/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,41464,42533,51294,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29185176$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Torke, Alexia M.</creatorcontrib><creatorcontrib>Callahan, Christopher M.</creatorcontrib><creatorcontrib>Sachs, Greg A.</creatorcontrib><creatorcontrib>Wocial, Lucia D.</creatorcontrib><creatorcontrib>Helft, Paul R.</creatorcontrib><creatorcontrib>Monahan, Patrick O.</creatorcontrib><creatorcontrib>Slaven, James E.</creatorcontrib><creatorcontrib>Montz, Kianna</creatorcontrib><creatorcontrib>Burke, Emily S.</creatorcontrib><creatorcontrib>Inger, Lev</creatorcontrib><title>Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study</title><title>Journal of general internal medicine : JGIM</title><addtitle>J GEN INTERN MED</addtitle><addtitle>J Gen Intern Med</addtitle><description>Background
Many hospitalized older adults require family surrogates to make decisions, but surrogates may perceive that the quality of medical decisions is low and may have poor psychological outcomes after the patient’s hospitalization.
Objective
To determine the relationship between communication quality and high-quality medical decisions, psychological well-being, and satisfaction for surrogates of hospitalized older adults.
Design
Observational study at three hospitals in a Midwest metropolitan area.
Participants
Hospitalized older adults (65+ years) admitted to medicine and medical intensive care units who were unable to make medical decisions, and their family surrogates. Among 799 eligible dyads, 364 (45.6%) completed the study.
Main Measures
Communication was assessed during hospitalization using the information and emotional support subscales of the Family Inpatient Communication Survey. Decision quality was assessed with the Decisional Conflict Scale. Outcomes assessed at baseline and 4–6 weeks post-discharge included anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), post-traumatic stress (Impact of Event Scale-Revised), and satisfaction (Hospital Consumer Assessment of Healthcare Providers and Systems).
Key Results
The mean patient age was 81.9 years (SD 8.32); 62% were women, and 28% African American. Among surrogates, 67% were adult children. Six to eight weeks post-discharge, 22.6% of surrogates reported anxiety (11.3% moderate–severe anxiety); 29% reported depression, (14.0% moderate–severe), and 14.6% had high levels of post-traumatic stress. Emotional support was associated with lower odds of anxiety (adjusted odds ratio [AOR] = 0.65, 95% CI 0.50, 0.85) and depression (AOR = 0.80, 95% CI 0.65, 0.99) at follow-up. In multivariable linear regression, emotional support was associated with lower post-traumatic stress (β = −0.30,
p
= 0.003) and higher decision quality (β = −0.44,
p
< 0.0001). Information was associated with higher post-traumatic stress (β = 0.23,
p
= 0.022) but also higher satisfaction (β = 0.61,
p
< 0.001).
Conclusions
Emotional support of hospital surrogates is consistently associated with better psychological outcomes and decision quality, suggesting an opportunity to improve decision making and well-being.</description><subject>Adults</subject><subject>Anxiety</subject><subject>Children</subject><subject>Communication</subject><subject>Decision making</subject><subject>Decisions</subject><subject>Discharge</subject><subject>Emotions</subject><subject>Health care</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Intensive care units</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mental depression</subject><subject>Metropolitan areas</subject><subject>Observational studies</subject><subject>Older people</subject><subject>Original Research</subject><subject>Post traumatic stress disorder</subject><subject>Psychological factors</subject><subject>Quality</subject><subject>Quality assessment</subject><subject>Social support</subject><subject>Well being</subject><issn>0884-8734</issn><issn>1525-1497</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kc1u1DAUhSMEotPCA7BBltiwCfg6ju1hgTSMKEWqNEUDYmk5sZO6cuKp7VQKj9EnxtMp5UdidRf3nHN_vqJ4AfgNYMzfRgCGWYmBl5QQUopHxQJqUpdAl_xxscBC0FLwih4VxzFeYQwVIeJpcUSWIGrgbFHcrv0wTKNtVbJ-RF8m5Wya0UUw2rYpoos4t5fe-T4rHPpunCs_GDv2SI0abbMpdqq9s9oRnarBuhltpxB8r5KJyHfozMedTTn2h9Fo47QJaKUnl-I7tBrRpokm3NwNz_nbNOn5WfGkUy6a5_f1pPh2-vHr-qw833z6vF6dl21dsVQCF6zrsBaK4brGNWeq66hWptIdgVZzrAypakEFAcZxa8A0DQCFpquIoLg6Kd4fcndTMxjdmjEF5eQu2EGFWXpl5d-d0V7K3t_IWlR0ySAHvL4PCP56MjHJwcY2v0iNxk9RwpJjwgmjJEtf_SO98lPIJ0dJMhZW0RrvN4KDqg0-xmC6h2UAyz1xeSAuM3G5Jy5F9rz884oHxy_EWUAOgphbY2_C79H_T_0Jomm5WA</recordid><startdate>20180301</startdate><enddate>20180301</enddate><creator>Torke, Alexia M.</creator><creator>Callahan, Christopher M.</creator><creator>Sachs, Greg A.</creator><creator>Wocial, Lucia D.</creator><creator>Helft, Paul R.</creator><creator>Monahan, Patrick O.</creator><creator>Slaven, James E.</creator><creator>Montz, Kianna</creator><creator>Burke, Emily S.</creator><creator>Inger, Lev</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180301</creationdate><title>Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study</title><author>Torke, Alexia M. ; Callahan, Christopher M. ; Sachs, Greg A. ; Wocial, Lucia D. ; Helft, Paul R. ; Monahan, Patrick O. ; Slaven, James E. ; Montz, Kianna ; Burke, Emily S. ; Inger, Lev</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c536t-1786ff0d8a60550576aff4dae3df21cd70ae23584821670ce1ebb1141bf328403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adults</topic><topic>Anxiety</topic><topic>Children</topic><topic>Communication</topic><topic>Decision making</topic><topic>Decisions</topic><topic>Discharge</topic><topic>Emotions</topic><topic>Health care</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Intensive care units</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mental depression</topic><topic>Metropolitan areas</topic><topic>Observational studies</topic><topic>Older people</topic><topic>Original Research</topic><topic>Post traumatic stress disorder</topic><topic>Psychological factors</topic><topic>Quality</topic><topic>Quality assessment</topic><topic>Social support</topic><topic>Well being</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Torke, Alexia M.</creatorcontrib><creatorcontrib>Callahan, Christopher M.</creatorcontrib><creatorcontrib>Sachs, Greg A.</creatorcontrib><creatorcontrib>Wocial, Lucia D.</creatorcontrib><creatorcontrib>Helft, Paul R.</creatorcontrib><creatorcontrib>Monahan, Patrick O.</creatorcontrib><creatorcontrib>Slaven, James E.</creatorcontrib><creatorcontrib>Montz, Kianna</creatorcontrib><creatorcontrib>Burke, Emily S.</creatorcontrib><creatorcontrib>Inger, Lev</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution 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Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of general internal medicine : JGIM</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Torke, Alexia M.</au><au>Callahan, Christopher M.</au><au>Sachs, Greg A.</au><au>Wocial, Lucia D.</au><au>Helft, Paul R.</au><au>Monahan, Patrick O.</au><au>Slaven, James E.</au><au>Montz, Kianna</au><au>Burke, Emily S.</au><au>Inger, Lev</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study</atitle><jtitle>Journal of general internal medicine : JGIM</jtitle><stitle>J GEN INTERN MED</stitle><addtitle>J Gen Intern Med</addtitle><date>2018-03-01</date><risdate>2018</risdate><volume>33</volume><issue>3</issue><spage>298</spage><epage>304</epage><pages>298-304</pages><issn>0884-8734</issn><eissn>1525-1497</eissn><abstract>Background
Many hospitalized older adults require family surrogates to make decisions, but surrogates may perceive that the quality of medical decisions is low and may have poor psychological outcomes after the patient’s hospitalization.
Objective
To determine the relationship between communication quality and high-quality medical decisions, psychological well-being, and satisfaction for surrogates of hospitalized older adults.
Design
Observational study at three hospitals in a Midwest metropolitan area.
Participants
Hospitalized older adults (65+ years) admitted to medicine and medical intensive care units who were unable to make medical decisions, and their family surrogates. Among 799 eligible dyads, 364 (45.6%) completed the study.
Main Measures
Communication was assessed during hospitalization using the information and emotional support subscales of the Family Inpatient Communication Survey. Decision quality was assessed with the Decisional Conflict Scale. Outcomes assessed at baseline and 4–6 weeks post-discharge included anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), post-traumatic stress (Impact of Event Scale-Revised), and satisfaction (Hospital Consumer Assessment of Healthcare Providers and Systems).
Key Results
The mean patient age was 81.9 years (SD 8.32); 62% were women, and 28% African American. Among surrogates, 67% were adult children. Six to eight weeks post-discharge, 22.6% of surrogates reported anxiety (11.3% moderate–severe anxiety); 29% reported depression, (14.0% moderate–severe), and 14.6% had high levels of post-traumatic stress. Emotional support was associated with lower odds of anxiety (adjusted odds ratio [AOR] = 0.65, 95% CI 0.50, 0.85) and depression (AOR = 0.80, 95% CI 0.65, 0.99) at follow-up. In multivariable linear regression, emotional support was associated with lower post-traumatic stress (β = −0.30,
p
= 0.003) and higher decision quality (β = −0.44,
p
< 0.0001). Information was associated with higher post-traumatic stress (β = 0.23,
p
= 0.022) but also higher satisfaction (β = 0.61,
p
< 0.001).
Conclusions
Emotional support of hospital surrogates is consistently associated with better psychological outcomes and decision quality, suggesting an opportunity to improve decision making and well-being.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>29185176</pmid><doi>10.1007/s11606-017-4222-8</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of general internal medicine : JGIM, 2018-03, Vol.33 (3), p.298-304 |
| issn | 0884-8734 1525-1497 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5834961 |
| source | EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection; SpringerLink Journals - AutoHoldings |
| subjects | Adults Anxiety Children Communication Decision making Decisions Discharge Emotions Health care Hospitalization Hospitals Intensive care units Internal Medicine Medicine Medicine & Public Health Mental depression Metropolitan areas Observational studies Older people Original Research Post traumatic stress disorder Psychological factors Quality Quality assessment Social support Well being |
| title | Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study |
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